Evaluation and management of brain metastatic patients with high-risk gestational trophoblastic tumors

• Published in: International journal of gynecological cancer Vol. 14; no. 5; pp. 966 - 971
• Main Authors: Ghaemmaghami, F., Behtash, N., Memarpour, N., Soleimani, K., Hanjani, P., Hashemi, F. A.
• Format: Journal Article
• Language: English
• Published: Oxford BMJ Publishing Group LTD 01.08.2004
• Subjects: Brain cancer; Metastasis
• ISSN: 1048-891X; 1525-1438
• DOI: 10.1136/ijgc-00009577-200409000-00033

A retrospective study to evaluate the characteristics of brain metastatic patients with gestational trophoblastic tumors (GTT) and to analyze the results of treatment has been performed. During 1996–2001, 40 patients with metastatic GTT were diagnosed at Vali-e-Asr Hospital, Tehran, Iran. Of them, nine with brain metastases, which were documented with the help of computed tomography scan, were evaluated retrospectively. Eight patients received EMA-EP regimen (etoposide, methotrexate, actinomycin, etoposide, and cisplatinum) and one received EMA-CO (etoposide, methotrexate, actinomycin, cyclophosphamide, and vincristin). All cases received whole brain irradiation therapy concurrently. The median age of the patients at diagnosis was 30 years (range: 17–53). Six of them were of early group (five with symptoms of central nervous system and one was detected during workup) and three were of late group (relapsed group). Five (56%) patients responded to treatment and four (44%) were deceased (three of them belonged to late group). It seems that multi-agent chemotherapy (EMA-EP) concurrently with whole brain irradiation results in acceptable survival rates in GTT patients with brain metastases.